{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T03:08:44Z","timestamp":1784603324186,"version":"3.55.0"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,6,28]],"date-time":"2021-06-28T00:00:00Z","timestamp":1624838400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The Lyon Consensus delineates impedance\u2010pH parameters that can demonstrate\/exclude gastro\u2010oesophageal reflux disease (GERD). In patients with acid exposure time between 4% and 6%, GERD diagnosis has been considered inconclusive. In these cases, mean nocturnal baseline impedance (MNBI) and post\u2010reflux swallow\u2010induced peristaltic wave (PSPW) index may either confirm or refute GERD diagnosis and represent predictors of proton pump inhibitor (PPI) response.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To investigate the diagnostic yield of MNBI and PSPW index and their relationship with PPI response in patients with inconclusive GERD diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Review of impedance\u2010pH tracings from PPI responder\/non\u2010responder patients with typical reflux symptoms. Multivariate regression analysis was performed to determine the association of MNBI and PSPW index to PPI response.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 233 patients evaluated, 145\/233 (62.2%) were PPI responders; 62 had conclusive and 65 inconclusive evidence of GERD, 46 had reflux hypersensitivity, and 60 functional heartburn. Abnormal MNBI and PSPW index were significantly more frequent in inconclusive GERD as compared to the functional heartburn group (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Within the inconclusive GERD group, 35\/65 (54%) patients were PPI responders and displayed a significantly higher proportion of cases with pathological MNBI or PSPW index as compared to non\u2010responders (32\/35 [91.4%] and 30\/35 [85.7%] vs 9\/30 [30%] and 7\/30 [23.3%], <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). By multivariate analysis, pathological PSPW index and\/or MNBI values were significantly associated with PPI response in all groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The present study highlights the value of MNBI and PSPW index as adjunctive metrics in characterising patients with inconclusive evidence of GERD and identifying those responsive to PPI treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.16481","type":"journal-article","created":{"date-parts":[[2021,6,28]],"date-time":"2021-06-28T17:55:19Z","timestamp":1624902919000},"page":"412-418","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["Novel impedance\u2010pH parameters are associated with proton pump inhibitor response in patients with inconclusive diagnosis of gastro\u2010oesophageal reflux disease according to Lyon 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